Dawn Nelson's story

Rare triple-organ transplant gives life to Louisville woman

LEXINGTON, Ky. (Nov. 20, 2012) — The University of Kentucky announced today that UK surgeons performed the first combined heart-lung transplant in Kentucky in 15 years. Dawn Nelson, 29, of Louisville, Ky., received two lungs and a heart from the same donor in one procedure at UK on July 7.

Dawn Nelson with her family and care team from the UK Transplant Center.

Triple organ transplants are rare

Combined heart-lung transplants are rare — only 27 were performed nationwide in 2011. They are generally performed on younger patients who have a fatal disease and cannot be treated with medication or other interventions.

Nelson was diagnosed with systemic lupus erythematosus at age 17 and rheumatoid arthritis at age 22. But four years ago, she also developed pulmonary hypertension, a deadly disease that attacks the blood vessels in the lungs and is fatal without timely treatment.

In Nelson's case, the disease destroyed her lungs, and her heart began to fail when it could no longer push blood into the lungs.

Dr. Wesley McConnell, a transplant pulmonologist with Kentuckiana Pulmonary Associates in Louisville began caring for Dawn two and a half years ago at their Pulmonary Hypertension Center. After her disease failed to respond to drug therapies, Dr. McConnell referred Dawn to UK on May 11 for an inpatient transplant evaluation.

"I knew that UK was her best option because they had the most experienced team in the state."

Her only chance for survival

"Dawn was extremely ill and it became clear that her only chance for survival would be a heart-lung transplant," McConnell said. "I knew that UK was her best option because they had the most experienced team in the state."

Nelson received her new lungs and heart on July 7. Dr. Charles Hoopes, director of the UK Transplant Center, performed the surgery, only the 7th such procedure to be performed at UK since it began transplantation in 1964. The last time UK performed this surgery was 1996.

"Although the surgery itself is relatively simple, combined heart-lung transplants are rare because they require three donor organs and are reserved for patients who are extremely ill with heart and lung failure," said Dr. Jay Zwischenberger, chair of the UK Department of Surgery. "They also require a great deal of infrastructure and support to perform successfully. At UK, we have that team in place, and moving forward we expect to perform one or two of these combined transplants per year."

More than four months after her surgery, Dawn Nelson continues to improve and grow stronger.

Improving and growing stronger

More than four months after her surgery, Nelson continues to improve and grow stronger. Dr. Enrique Diaz, medical director for lung transplantation, and Dr. Navin Rajagopalan, medical director of cardiac transplantation, both provide follow-up care for Nelson at UK. Additionally, she continues to see McConnell at the KPA practice in Louisville.

"Dawn is doing quite well. At the time of transplant, she was so sick she only weighed about 80 pounds," Rajagopalan said. "Now, she feels well, is gaining weight, and is able to do things that she had not been able to do for years.”

Collaborative treatment

Nelson's collaborative treatment is a prime example of the partnership between Louisville and Lexington doctors that UK is trying to cultivate, says Dr. Michael Karpf, UK executive vice president for health affairs.

"This is an example of the success and lives changed for the better by UK HealthCare’s partnerships," said Dr. Michael Karpf, UK executive vice president for health affairs. “Our goal is to continue to provide highly advanced subspecialty care such as Ms. Nelson’s complex transplant to patients like her who otherwise would either have to leave the Commonwealth or worse, not receive the treatment needed.”

Outreach transplant and specialty clinic

In November 2010, UK in collaboration with Norton HealthCare opened up an outreach Transplant and Specialty Clinic at Norton Audubon Hospital to provide comprehensive pre- and post-transplant care for patients. The partnership ensures that patients like Nelson will not have to leave the state to receive complex acute care or follow-up treatment.